A prospective study of G-CSF-primed bone marrow as a stem-cell source for allogeneic bone marrow transplantation in children: A Pediatric Blood and Marrow Transplant Consortium (PBMTC) study

Haydar Frangoul, Eneida R. Nemecek, David D Billheimer, Michael A. Pulsipher, Shakila Khan, Ann Woolfrey, Becky Manes, Catherine Cole, Mark C. Walters, Mouhab Ayas, Yaddanapudi Ravindranath, John E. Levine, Stephan A. Grupp

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38 Scopus citations

Abstract

A prospective multicenter trial was conducted to evaluate the safety and feasibility of granulocyte colony-stimulating factor (G-CSF)-primed bone marrow (G-BM) in children receiving allogeneic bone marrow transplantation (BMT). A total of 42 children with a median age of 9.8 years (range, 0.8-17 years) were enrolled. Donors with median age of 9.2 years (range, 1.1-22 years) received 5 μg/kg per day of subcutaneous G-CSF for 5 consecutive days. BM was harvested on the fifth day. No donor experienced complications related to G-CSF administration or marrow harvest. Median nucleated (NC) and CD34 cells infused was 6.7 × 108/kg (range, 2.4-18.5 × 108/kg) and 7.4 × 106/kg (range, 2-27.6 × 106/kg), respectively. Neutrophil and platelet engraftment was at a median of 19 days (range, 13-28 days) and 20 days (range, 9-44 days), respectively. A total of 13 (32%) patients developed grade 2 graft-versus-host disease (GVHD), and 5 (13%) of 40 evaluable patients developed chronic GVHD (3 limited and 2 extensive). Higher cell dose was not associated with increased risk of acute or chronic GVHD. Overall survival and event-free survival at 2 years were 81% and 69%, respectively. Collection of G-BM from pediatric donors is safe, and can result in high NC and CD34 cell doses that facilitate engraftment after myeloablative BMT without a discernable increase in the risk of GVHD.

Original languageEnglish (US)
Pages (from-to)4584-4587
Number of pages4
JournalBlood
Volume110
Issue number13
DOIs
Publication statusPublished - Dec 15 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Hematology

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